How Long Can You Live With Ascites?

Ascites is the buildup of fluid in the abdomen, usually caused by advanced liver disease, but also by heart failure, kidney disease, or cancer. Because ascites often signals serious underlying illness, many people worry about life expectancy and what the future holds.

There is no single answer to how long a person can live with ascites. Prognosis depends on the cause, severity, response to treatment, and overall health. With proper care, many people live months or years with manageable symptoms. Others may become seriously ill if complications develop.

This guide explains what influences life expectancy, how treatment improves outcomes, and what steps can help protect long-term health.

Why Ascites Affects Life Expectancy

Ascites is not a disease itself but a sign of significant underlying stress in the body.

Common causes include:

• Cirrhosis (the most common cause)

• Heart failure

• Kidney failure or nephrotic syndrome

• Cancer (malignant ascites)

• Severe infections

When the abdomen fills with fluid, it indicates that the liver, kidneys, or heart are struggling to maintain normal fluid balance.

Prognosis depends heavily on the underlying cause.

Read on At-Home Liver Tests: A Comprehensive Guide.

How Long Can You Live With Ascites

Here is what research and clinical experience show.

1. Ascites Caused by Cirrhosis

Cirrhosis-related ascites is serious because it indicates advanced liver disease. Studies show that:

• About 50 percent of people with cirrhotic ascites survive 2 years without liver transplant.

• Life expectancy drops further if ascites becomes refractory (not responding to diuretics).

However, outcomes vary widely. Some people live many years with good medical care, especially if:

• They stop drinking alcohol

• They manage sodium intake

• They take diuretics regularly

• They receive treatment for the underlying liver condition

• They avoid infections and kidney problems

2. Refractory Ascites

Refractory ascites does not improve with medications and requires repeated drainage.

In these cases, life expectancy may shorten without advanced interventions like:

• TIPS procedure to reduce portal pressure

• Liver transplant, which can completely resolve ascites

3. Malignant Ascites (Cancer-Related)

Ascites caused by cancer has a different outlook.

In many cases, malignant ascites indicates advanced cancer, and average life expectancy may range from:

• A few weeks to several months, depending on the cancer type and treatment response

Some cancers, especially ovarian cancer, may respond well to chemotherapy, improving survival and reducing ascites.

4. Ascites From Heart or Kidney Failure

If ascites is due to heart or kidney failure:

• Life expectancy depends on how well the condition responds to treatment

• Many patients improve significantly with proper medical management

Heart failure–related ascites may improve when heart medications are optimized. Kidney disease–related ascites may stabilize with dialysis or improved kidney care.

Check out our guide on The Complete Guide to At-Home Kidney Function Tests to keep ahead of your kidney health.

5. Infection-Related Ascites

Infections such as tuberculosis can cause temporary ascites.

• With treatment, people may recover fully.

• Life expectancy is generally favorable once the infection is controlled.

Factors That Influence Life Expectancy

Several variables determine how long someone can live with ascites.

1. Cause of the Ascites

This is the strongest predictor. Cirrhosis and cancer have different outcomes and treatment options.

2. Response to Treatment

People who respond well to diuretics, paracentesis, or disease-specific therapy often live longer.

3. Nutritional Status

Malnutrition is common in liver disease and cancer and can worsen outcomes.

4. Kidney Function

Kidney strain or failure significantly reduces life expectancy.

5. Presence of Infections

A condition called spontaneous bacterial peritonitis (SBP) is dangerous and needs immediate treatment.

6. Eligibility for Liver Transplant

For people with cirrhosis, transplant dramatically improves survival.

Can Ascites Be Treated or Reversed?

Yes, in many cases—especially if caught early.

Treatment Options Include:

1. Low-Sodium Diet to reduce fluid retention.

2. Diuretics such as spironolactone and furosemide.

3. Paracentesis for draining fluid when swelling causes discomfort.

4. TIPS Procedure for advanced cirrhosis with difficult-to-control ascites.

5. Treating the underlying cause, such as:

• Antivirals for hepatitis

• Chemotherapy for cancer

• Heart failure medications

• Dialysis or kidney treatment

6. Liver Transplant, which can cure cirrhosis-related ascites.

Improving Survival With Ascites

While ascites can be serious, several steps can help improve quality and length of life.

1. Avoid All Alcohol

Alcohol worsens liver disease and increases fluid buildup.

2. Follow a Low-Sodium Diet

Aim for 1500 to 2000 mg of sodium per day.

3. Take Medications as Directed

Do not skip diuretics unless advised by your doctor.

4. Monitor Weight Daily

Sudden increases may mean fluid buildup.

5. Manage Blood Pressure, Blood Sugar, and Cholesterol

These help protect the liver, heart, and kidneys.

6. Treat Infections Quickly

Fever, chills, or abdominal pain require urgent evaluation.

7. Attend Regular Follow-Up Appointments

Consistent care improves outcomes.

When Ascites Requires Emergency Care

Seek immediate help if you experience:

• Severe abdominal pain

• Fever or chills

• Confusion or drowsiness

• Vomiting blood

• Rapid worsening of swelling

• Difficulty breathing

These may indicate infection, bleeding, or worsening organ function.

The Bottom Line

How long you can live with ascites depends on what is causing it and how well it responds to treatment.

• With early treatment and lifestyle changes, many people with liver-related ascites live several years.

• Refractory ascites or malignant ascites may carry a more serious prognosis.

• Heart, kidney, or infection-related ascites can improve significantly when the underlying condition is treated.

Regardless of the cause, early evaluation, proper treatment, and healthy lifestyle choices can significantly improve both quality of life and survival.

Concerned about ascites or liver health?
You can take an at-home liver, kidney, and metabolic panel test through Ribbon Checkup and get results instantly.

Explore liver and metabolic tests 

Related Resources

• What Are the 7 Signs Your Liver Is Dying?

• Life Expectancy with Fatty Liver Disease: What You Need to Know

• Signs Your Liver Is Healing: What to Expect and How to Support Recovery

References

References

Huelin, P., Fortea, J. I., Crespo, J., & Fábrega, E. (2017). Ascites: Treatment, Complications, and Prognosis. InTech EBooks. https://doi.org/10.5772/intechopen.70384 

Long term drains to treat ascites. (2024, November 14). Retrieved November 21, 2025, from Cancerresearchuk.org website: https://www.cancerresearchuk.org/about-cancer/coping/physically/fluid-abdomen-ascites/long-term-drains 

Rutherford, R. (2023, August 14). Basic Management of Refractory Ascites: Part 2 - Hospital Procedures Consultants. Retrieved November 21, 2025, from Hospital Procedures Consultants website: https://hospitalprocedures.org/basic-management-of-refractory-ascites-part-2/ 

Seladi-Schulman, J. (2024, December 4). How Does Cirrhosis Cause Ascites? Retrieved November 21, 2025, from Healthline website: https://www.healthline.com/health/liver-cirrhosis-ascites#faq 

Sinicrope, F. A. (2025). Ascites. Retrieved November 21, 2025, from Nih.gov website: https://www.ncbi.nlm.nih.gov/books/NBK12901/ 

 

 

Frequently Asked Questions

Q: How long can you live with ascites?

A: It depends on the cause. People with cirrhosis-related ascites may live several years with good treatment, while malignant ascites from cancer may shorten life expectancy to months. Treatable causes like infection or heart failure have a better outlook.

Q: Is ascites a sign of end-stage liver disease?

A: Often, yes. Ascites is one of the strongest indicators of advanced cirrhosis and increased risk of complications. However, many patients still live years with proper care.

Q: How long can you live with cirrhosis and ascites?

A: Research shows about 50% of people survive two years without a liver transplant, but many live longer when alcohol is avoided, sodium is restricted, and complications are treated early.

Q: Is malignant ascites always terminal?

A: Malignant ascites usually indicates advanced cancer, and survival ranges from weeks to months. Some cancers, especially ovarian cancer may respond well to treatment, improving symptoms and extending life.

Q: Can ascites ever be reversed?

A: Yes, in some cases. Ascites caused by early liver disease, infections, heart failure, or kidney issues may improve or fully resolve when the underlying condition is treated.

Q: Does refractory ascites mean a poor prognosis?

A: Refractory ascites—fluid that doesn’t respond to diuretics indicates advanced disease. Life expectancy is shorter unless treatments like TIPS or liver transplant are possible.

Q: What treatments improve survival in ascites?

A: Key treatments include sodium restriction, diuretics, paracentesis, TIPS, treating the underlying condition, and liver transplant for eligible patients.

Q: What symptoms mean ascites is getting worse?

A: Worsening abdominal swelling, shortness of breath, leg swelling, rapid weight gain, confusion, or fever signal progression or possible infection.

Q: When is ascites a medical emergency?

A: Seek emergency care if you have fever, chills, severe pain, vomiting blood, confusion, or trouble breathing—these may indicate infection or organ decline.

Q: Can lifestyle changes extend life with ascites?

A: Yes. Avoiding alcohol, limiting sodium, managing weight, monitoring blood pressure and diabetes, and treating infections early all improve survival.